خانه ارائه دهندگان و شرکا طرح مراقبت هماهنگ و Cal MediConnect​​ 

ابتکار مراقبت هماهنگ و Cal MediConnect​​ 

بازگشت به مراقبت یکپارچه برای ذینفعان واجد شرایط دوگانه​​ 

آیا شما عضو Cal MediConnect هستید؟ درباره آینده Cal MediConnect بیشتر بدانید.​​ 

Passage of the Coordinated Care Initiative (CCI) in July 2012 marked an important step toward transforming California’s Medi-Cal (Medicaid) care delivery system to better serve the state’s low-income seniors and persons with disabilities. Building upon many years of stakeholder discussions, the CCI begins the process of integrating delivery of medical, behavioral, and long-term care services and provides a road map to integrate Medicare and Medi-Cal for beneficiaries of both programs, called “dual eligible” beneficiaries.​​   

Created through a public process involving stakeholders and health care consumers, the CCI was enacted through Senate Bill 1008 (Chapter 33, Statutes of 2012) and Senate Bill 1036 (Chapter 45, Statutes of 2012).​​ 

The CCI was implemented in seven counties beginning in 2014. The seven counties are Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.​​ 

بخش‌های اصلی ابتکار مراقبت هماهنگ​​ 

  • Cal MediConnect: یک طرح سلامت داوطلبانه برای ذینفعان دوگانه واجد شرایط برای دریافت خدمات هماهنگ پزشکی، رفتاری، سازمانی بلندمدت و خدمات مبتنی بر خانه و جامعه از طریق یک سیستم تحویل سازمان‌یافته واحد. Cal MediConnect مزایای Medicare و Medi-Cal را با مزایای اضافی هماهنگی مراقبت ترکیب می کند.​​   
  • پشتیبانی‌ها و خدمات طولانی‌مدت مدیریت‌شده Medi-Cal (MLTSS): همه ذینفعان Medi-Cal، از جمله ذینفعان واجد شرایط دوگانه، در شهرستان‌های CCI برای دریافت مزایای Medi-Cal خود، از جمله LTSS، ملزم به ملحق شدن به طرح سلامت مراقبت مدیریت‌شده Medi-Cal هستند. و مزایای کامل Medicare.​​ 

What’s New with Cal MediConnect​​ 

Under the California Advancing and Innovating Medi-Cal (CalAIM) initiative, starting on January 1, 2023, Cal MediConnect members will be transitioned to MMPs, or Medi-Medi Plans. MMPs is the California-specific program name for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs). Under exclusively aligned enrollment, beneficiaries can enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration. DHCS will work with health plans, stakeholders, and the Centers for Medicare & Medicaid Services (CMS) to transition and expand integrated care statewide.  This policy is intended to help meet the statewide goals of improved care integration and person-centered care, under both the CalAIM initiative and the California Master Plan for Aging.​​ 

DHCS is convening the monthly public CalAIM MLTSS & Duals Integration Workgroup to work with stakeholders to support this transition. Information on how to register for the CalAIM MLTSS & Duals Integration Stakeholder Workgroup, and background materials from previous workgroup meetings is available here.​​ 

اطلاعات کلی​​ 

  • How to Enroll – Shares basic information about how to enroll in Cal MediConnect.​​ 
  • Cal MediConnect Benefits and Services – Includes basic information about CMC’s benefits/services.​​ 
  • PACE – Includes brief background on the PACE program, a link to CalPACE, and four PACE FAQs.​​ 
  • Health Plan 101 – An explanation of different health plan components and a series of related questions and answers.​​ 

برگه اطلاعات CCI​​ 

  1. منابع برای ذینفعان​​ 

     2. منابع برای ارائه دهندگان​​ 

     3. منابع برای مدافعان​​ 

     4. اطلاعات تاریخی CCI​​ 

قانون مصوب​​ 

نسخه های پیشین زبان قانونگذاری​​ 

For more information about the Coordinated Care Initiative and Cal MediConnect, please visit the Integrated Care for Dual Eligible Beneficiaries webpage.​​